Question 1

What is HCPCS code L6647?

Accepted Answer

HCPCS code L6647 is "Shoulder lock actuator". Upper extremity addition, shoulder lock mechanism, body powered actuator

Question 2

What category is L6647 in?

Accepted Answer

L6647 belongs to HCPCS Category L (Orthotics and Prosthetics).

Question 3

When should I use HCPCS code L6647?

Accepted Answer

Use L6647 when billing for shoulder lock actuator. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is L6647 covered by Medicare?

Accepted Answer

Coverage for L6647 (Shoulder lock actuator) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for L6647?

Accepted Answer

Documentation for L6647 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).